Cataract

A Cataract is a progressive clouding of the eye’s natural lens that interferes with light passing into the eye and results in decreased vision. Dr. Gulani teaches cataract surgery all over the world and believes in Custom-Designing vision for each patient through their cataract surgery by tailoring his 3T concept (Technique, Technology & Target)

TECHNIQUE:

“No Needles”, “No Patch” & “No Stitch” Cataract Surgery

Dr. Gulani performs cataract surgery as an outpatient procedure with no needles or shots, no stitches, no patch and also, no hospital stay. The eye is numbed with drops and patient is lightly sedated and under the surveillance of an anesthetist to ensure comfort throughout the procedure. He uses sophisticated, computer programmed technology like the Femtosecond LASER or Phacoemulsification (Ultra sound) along with his invented Diamond instruments to customize the safe and accurate removal of your cataract.

Since cataract was a lens to begin with; its removal requires replacement with an artificial intra ocular lens implant (IOL)which is inserted through the microincision into the capsular bag of the cataract for support. Once inside the eye, the lens spontaneously unfolds as it is placed into permanent position. No sutures are required because the small incision is self-sealing.

Cataract surgery of one eye can be followed by second eye surgery at least one week apart. In some cases, the capsular bag of the cataract that holds the IOL can become hazy over time and needs a special YAG laser procedure (which is outpatient, usually covered by insurance and takes just minutes).

TECHNOLOGY

Computer programmed, LASER accurate & Diamond specific

Advancements in IOL designs now give patients the option to choose a Monofocal, Multifocal, Accommodating or Toric IOL to replace the eye’s natural lens. Both Monofocal or Toric IOL correct nearsightedness and farsightedness and provide excellent vision at one point of focus, usually for distance. Toric IOLs also correct astigmatism.

In contrast to Monofocal and Toric IOLs, Multifocal and Accommodating IOLs, also knows as Presbyopia-Correcting IOLs ((like bifocal / multifocal / progressive glasses), provide a range of vision at near and distance, thereby allowing a person to perform most of their daily activities with reduced or no dependence on glasses. A wide choice of Multifocal, premium lenses like the ReStor, ReZoom, Tecnis and Crystalens are available for Dr. Gulani to select the best lens optics suited for your eyes.

Ask about the new breakthrough in cataract surgery; the Femtosecond LASER to perform truly Blade Less surgery in replacing many of the surgical steps done by hand.

TARGET

Dr. Gulani teaches surgeons that there are two parts to cataract surgery today; one is the surgery itself and second, is the pursuit of the custom-planned vision goal (Target) best suited for each individual patient. Thus, he believes that cataract surgery should be an “Avenue” leading to that higher cause.

These Target could range from Mono Vision, Blend Vision, Multifocal or Pseudo-accommodative Vision to differentially arranging each eye’s optics so they work together to provide the best Vision range.

Given the individual healing pattern of each patient, Dr. Gulani likes to reiterate that no surgery or technology can guarantee vision without glasses but every effort can be made to select technology, technique and target to best aim for “Vision Freedom”.

Costs & Payment Plans

If you are over the age of 65 and have significant cataracts, Medicare and most insurances will cover (based on your individual contracts that you can confirm) the cost of cataract surgery along with “Monofocal” IOL. However, the additional cost of upgrading to a New Technology IOL or using the LASER assisted surgery is not covered by Medicare nor by private insurance companies because they are not considered medically necessary.

You can take advantage of a number of payment plans which can help you pay for your Custom cataract surgery with New Technology choices selected in your best interest.

Our staff will explain these costs and answer any questions you may have about risks and complications of Custom Cataract surgery, choice of technology and enhancement procedures.

Take this opportunity to plan for your VISION and please have all of your questions answered before giving your consent for surgery.

CATARACT surgery raised to an ART: The GULANI difference !

Designing Vision with Cataract Surgery.

Even though millions of cataract surgeries are performed throughout the world every year and it is called a Routine procedure, Dr. Gulani teaches eye surgeons worldwide that “No Cataract surgery should be ROUTINE”.

Cataract surgery is an ENDEAVOR to help patients see what they have been missing and also an opportunity to plan for the BEST Vision they can have for the REST of their Life”- Gulani AC, M.D.

With such an outlook, Dr. Gulani encourages eye doctors to classify every Cataract patient into four categories and then individually plan to address all of their correctable visual issues using Customized Cataract Surgery with New Generation Lens Implants and / or staged Laser Vision Surgery.

Dr. Gulani approaches each eye like a camera in evaluating the optics of the entire eye and planning a surgery best suited towards perfecting vision for that eye individually.

Just like a camera, the eye has a cornea (viewfinder), the shape of which decides vision. Nearsighted ( Myopic) corneas are steep or more curved, Farsighted ( Hyperopic) corneas are flatter and Astigmatic corneas are shaped like a football (oval) as opposed to being shaped like a basketball (spherical). Thus nearly all cornea-based refractive surgeries (including Lasik Laser Vision Surgery) focus on re-shaping a patient’s cornea.

The next imaging structure in the eye is the lens (very much like the lens in the camera).

You are born with a clear natural lens which over time (with age) becomes cloudy and is now called a CATARACT. Since this cataract was a lens to begin with, it needs to be replaced by an artificial Lens implant.

Many people after the age of 40 experience Presbyopia or blurred vision at near points, such as when reading, sewing or working at the computer and need reading glasses or “cheaters”.

Dr. Gulani likes to describe this as an age-related loss of the “Zooming power” (tele & wide like a camera) of your natural lens inside your eye.

Now, if you combine the analogy of a camera to a cataract patient, most Cataract patients do wear some glasses or contact lenses for associated Nearsightedness or Farsightedness and or Astigmatism and of course, they all have Presbyopia (since they are usually more than 40 years old).

For example, a cataract patient may be wearing Bifocal glasses for farsightedness, astigmatism and presbyopia (reading).

The fact that this patient has a medically significant cataract is confirmed. Now, instead of taking such a patient, calling them “Routine” and rushing them through a “Cataract surgery Mill”, Dr. Gulani suggests taking this opportunity and correcting all of this patient’s visual problems through that one surgery that they need anyways ie. Cataract surgery.

Custom Planning for Customized Vision:

When designing a Customized Cataract surgery plan, Dr. Gulani performs a wide range of State of the Art diagnostic tests to determine his 3

Additionally, given Dr. Gulani’s combined knowledge of the technologies as well as the optics of the eye, he measures Higher order Aberrations along with Secondary Refractive errors and Optical Zones with Corneal Asphericity to further customize his approach.

Armed with all this information, he then dedicates a plan personalized for each patient.

Getting back to the above patient example with 4 visual issues, such a patient can elect to have cataract surgery using a Multifocal lens implant that can correct 3 out of 4 visual issues (1, 2 & 4). Resulting in only one visual issue remaining which is Astigmatism(3). This being a function of the foot ball shaped cornea, it can be addressed with Advanced Laser Vision Surgery as planned a month after cataract surgery.

We both are living examples of Perfect Vision at distance and Near- Without Glasses.

Thus this patient who could have landed as a “Routine” case with “Routine “

Cataract surgery now has a customized plan for their individual eye and vision goals.

Further categories of patients with cataracts:

Category II: Patients who have had eye surgeries in the past to correct their vision (ie. Lasik, Radial Keratotomy etc) may present with either long term side effects of that surgery, gradually decreasing vision over time or need for modern technology fine tuning.

Their vision can be planned using Cataract surgery with specific, New Technology Lens Implants followed by staged, Advanced Laser Vision surgery to excellent visual outcomes.

After my cataract surgery, my field of vision was improved, my near vision was improved and driving at night is now easier. Dr. Donald Morford (RK patient with ReStor Lens implant)

In such cases, Dr.Gulani plans for the endpoint of vision by first manipulating the optics of the eye using New Technology IOLs with Cataract surgery in preparation for Laser Corneoplastique, INTACS or Lamellar Corneal Transplants.

Category IV. Patients who have undergone cataract surgery elsewhere and have a wrong IOL power in place, complication of the surgery or even those who simply want their cataract surgery of the past ‘Fine Tuned” to 21st century vision expectations.

In such cases, Dr. Gulani studies the case and plans to exchange their IOL for a modern New Technology IOL, “Piggy Backs” an IOL on top of their old IOL or even uses Advanced Laser surgery to correct their residual glasses prescription so they can see without any glasses or contact lenses.

Thus patients with previous cataract surgery can also hope to see without any glasses today.

My vision is excellent! Dr. Gulani’s word is as good as gold! Gayle Washnock (Laser Vision Surgery after Cataract surgery)

Being a world renowned Vision Surgery expert, Dr. Gulani is uniquely talented in both, Advanced Cataract & Laser Vision Surgery and uses this experience along with his in depth knowledge of the Optical system of the eye in selecting customized techniques with the full range of technology choices including combination surgeries to result in individualizing Vision goals thereby raising Cataract Surgery itself to an ART.

I flew from San Francisco for the best cataract surgeon in the world. Thank you for your expertise Dr. Gulani - Prem Hinduja, San Francisco.

I traveled from New York to seek the Cataract surgeon who teaches other Cataract surgeons worldwide. I am amazed at my vision today- Marvin Glassberg, New York

Inventor of award-winning Gulani Series of Innovative Surgery Instruments, Dr. Gulani is a distinguished Teaching faculty for Cataract & Premium Multifocal Lenses for major conferences and publications throughout the world.

Thanks again Dr. Gulani, for your expertise, compassion, professionalism, friendship and courage to do what you believe. You are the best! Dr. Jane Cai, Orlando.

I was amazed with my improved vision after placement of the ReStor lenses. Dr.Gulani’s world renowned expertise is only matched with his personal touch for each patient.

Dr. Donald Morford, Jacksonville.

Dr. Gulani designed my cataract surgery using Toric Lenses. His drive for perfection raises the bar for all of us in the medical field- Dr. Bruce Buchanan, Fernandina Beach.